1982, 01-28 Permit: 82A-676 WoodstovePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
. 19403 4th Ave.
LEGAL DESCRIPTION — SEE ATTACHED
LOT
BLOCK
SUBDIVISION
3.
OWNER
George Anderson
PHONE
926-6597
PARC NUM.3ER/S
ADDRESS
. 19403 4th Ave.
ZIP
99016
Actual Set Backs in Feet
North 'South
East
West
CONTRACTOR
Valley Fireplace Inc.
PHONE
922-2780
Size of Parcel
Zone Classification
ADDRESS
E. 16610 Sprague Ave.
ZIP
99037
Type Const.
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
DESIGNER Contractor License No.
5. ADDRESS VA LL !SF 626 01131
PHONE
Building lding Area in Sq. Ft.
ZIP
Main Floor I Upper Floors
Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW
O BLD.
O ALT.
O PLMB.
O AD'N.
O MECH.
O RPL.
O M.H.
O MVE.
O POOL
0 OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK Install "Blaze Princess" woodstove
8. into existing prefabricatedhi
cmney.
VALUATION SOURCE GAS ELECTRIC WATER
OF
9. UTILITIES,
Enum. Dist. I Location (Area)
SEWER
Ownership
Public ❑ Private 0
USE CODE
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance -of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIO
DATE OF APPLICATION
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Enginee
Utilities
Plans Examiner
SEPA Checklist
Building chnici
SIGNATURE OF APPLICANT
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
7@
04* *2000
* 2000
* 2000'6
A *0.00
67.52
01-28-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O1;-2&-8'2`
67,65 *2QOOa1
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL